Teeth are composed of enamel on the outside and the dentin which lies just under the enamel. Dentin contains very small tubes that have fluid in them. When hot, cold, chemicals such as whitening agents or sweets pass by the surface of the dentin on the exposed roots and edges of teeth it moves the fluid in the micro tubes and this causes the pain by stimulating the nerve. So when pain is felt it is actually an indirect contact with the nerve through this system and not a direct touching of the nerve.
The following are the most frequent causes of tooth sensitivity:
- Brushing with excessive pressure with hard toothbrush bristles. Over time this aggressive act will take away the gum tissue, the bone and then the tooth leading to exposed root dentin which will make the teeth sensitive. The use of a soft toothbrush using a gentle circular motion aiming at the gumline is the best way to safely brush the teeth without harm. I am often asked what is the best toothbrush? I say a soft manual brush or even better is an electric brush like the Sonicare. They are gentle on the teeth and effective on plaque removal while infusing oxygen into the plaque which helps to kill the bacteria between the teeth.
- Periodontal disease will cause bone loss around the teeth giving the “long in the teeth” appearance. Some people falsely believe that this is a part of the natural aging process but it isn’t. Periodontal disease is caused by a bacterial invasion under the gum line which eventually causes the bone to be lost. Smokers and uncontrolled diabetics are the ones who are most likely to be diagnosed with this disease.
- Grinding of the teeth from stress can create loss of bone and tooth structure where the root meets the gum. This is called an abfraction and is like a deep notch in the tooth. When one grinds their teeth the teeth flex and under the right conditions these notches can deepen and become sensitive. A small guard can prevent this from happening and an evaluation is necessary to make sure the bite is proper. Sometimes it may be necessary to adjust the bite.
- Abrasive toothpastes such as those containing baking soda can be harmful and abrade the tooth roots.
- Acidic foods and beverages such as soft drinks can cause tooth pain by decaying the tooth. I had a patient recently ask me if lemon in the water can cause the sensitive teeth because she was using a lot of lemon. This certainly increases the acid level in the mouth and causes them to be sensitive. Acid reflux especially at night is a contributing factor in that the stomach acid is very strong which leads to loss of enamel. Bulimia also makes the teeth exposed to the strong acids in the stomach, leading to really sensitive teeth.
These are the most common causes that lead to sensitive teeth. Treatment includes such things as: fluoride rinses at home, tooth pastes such as Sensodine, Renamel and a number of other toothpastes which have a chemicals in them that literally “clogs” up the small microtubes in the dentin. When these get “clogged up” they can’t transmit the fluid within the micro tubes and pain is reduced. We have stronger “clogging agents” that can be applied in the office which can make a significant difference in pain. You must remember that hard tooth brushing and acids will dissolve the reparative plugs that are formed so it is necessary to change the habits that have created the sensitive teeth in the first place. It is best to visit your dentist to have this evaluated. If you don’t have a current dental home then I would be happy to evaluate your situation so give us a call at (586)247-3500.
About The Author
Dr. Robert Antolak, DDS graduated from the University of Michigan in 1987 with his Doctor of Dental Surgery degree. He is dedicated to providing the highest quality and appropriate cosmetic, sedation and general dentistry in the most comfortable and gentle way possible. Because being a dentist has been a lifelong dream, Dr. Antolak has a passion for the profession. He enjoys helping people feel better about their smiles and therefore their self-image with dental implant and cosmetic dentistry. His Dental Practice is located in Shelby Township, Michigan. For more information visit The Gentle Dentist.